Linkage to Care and Prevention

Actively promoting and facilitating timely access to specialized healthcare services, including antiretroviral therapy (ART) and regular monitoring, can significantly impact the health outcomes of their patients. Linkage to care is important in ensuring early diagnosis, effective management of the infection, and achieving viral suppression, which not only benefits the individual but also helps in preventing disease progression and transmission to others.

HIV Care Continuum

There are five steps to the HIV Care Continuum:

  1. Diagnosis of HIV infection
  2. Linkage to HIV medical care
  3. Receipt of HIV medical care
  4. Retention in medical care
  5. Achievement and maintenance of viral suppression

Status-Neutral Approach to HIV Care

  • HIV screening is the first step in CDC’s statusneutral approach to prevention and care. It all starts with an HIV test, but routine HIV screening is only the first step. To improve their health outcomes, all people with HIV must have access to the full continuum of HIV prevention and care.
  • Linking your patients to prevention and care services is essential. The HIV prevention and care continuum is an ongoing, lifelong process that encompasses HIV testing, prevention, and care. CDC’s status-neutral approach to HIV prevention and care ensures that all patients can benefit from quality HIV prevention and care, regardless of their HIV status.
  • Patients who have negative HIV tests should be offered prevention tools.
  • Patients who have positive HIV tests should be linked to HIV treatment and care.

Immediate ART Importance:

  • Immediate antiretroviral therapy (iART) refers to starting HIV treatment as soon as possible when an individual is diagnosed with HIV, generally within 96 hours of diagnosis.
  • iART should be done on the first clinic visit and even on the same day of HIV diagnosis.
  • iART is beneficial for all people who are diagnosed with HIV, regardless of how long they have been living with HIV or how healthy they are.
  • iART can bring benefits to one’s personal health, and reduces the risk of onward transmission of HIV, because individuals who achieve viral load suppression do not transmit HIV to others.

Retention in HIV Care

  • Retention in HIV care refers to the ability of individuals living with HIV to consistently engage in and adhere to medical care, including regular appointments with healthcare providers, timely initiation and maintenance of antiretroviral therapy (ART), and ongoing monitoring of their disease progression.
  • This is crucial in managing HIV as a chronic condition and achieving optimal health outcomes for people living with the virus.
  • According to CDC, Of the estimated 1.2 million people with HIV in the United States in 2019, about 66% received HIV medical care, 50% were retained in care, and 56.8% were virally suppressed or undetectable.
  • The following are approaches to help people stay in care and treatment:
    • Reduce barriers to HIV care for your patients.
      • Clinic-wide marketing
      • “Data to Care” approaches
      • Retention and re-engagement support
      • A patient navigator
      • Medication adherence support
      • Local or state health departments or local community-based organizations
    • Build positive relationships with your patients to retain them in care.
      • Help patients modify behaviors that lead to poor retention in HIV care
      • Foster patient trust
      • Allow open communication and collaborative decision making
      • Demonstrate interest in addressing barriers to care
    • Engage in brief conversations with your patients at every office visit.

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